Almost everyone has experienced insomnia at some point. An occasional night spent tossing and turning can be annoying, but for many people it’s a serious problem. About 1 in 4 Americans suffer from insomnia often enough to interfere with daily activities.
Dr. Alan Haber, Director of the Sleep Laboratory at Graduate Hospital in Philadelphia defines insomnia as “difficulty falling asleep (sleep-onset insomnia) or maintaining sleep (sleep-maintenance insomnia) associated with impairment of daytime function.” The average adult needs about 8 hours of sleep each night. Not getting enough can result in irritability, inattentiveness and problems with memory.
The causes of insomnia are almost countless, but most often it is caused by depression or anxiety brought on by problems such as family illness or financial stress. Next most common is a type of performance anxiety when it comes to sleeping. “Simply stated, the fear of sleeplessness causes these individuals to become increasingly stressed as nighttime approaches, and they become chronically unable to relax sufficiently to allow sleep onset at night.” explains Dr. Haber. The third most common cause is associated with medical disorders, such as asthma or acid reflux.
Studies have shown that women are much more likely to experience difficulty sleeping than men, although the exact reasons are not clear. It may be that women are simply more likely to report the problem to their physician. Hormonal fluctuations may also be a factor. “In particular, falling estrogen and progesterone levels are thought to contribute to premenstrual- and menopause-associated sleep disruption.” Anxiety and depression are seen much more often in women, and they can lead to insomnia as well. Since mothers are usually responsible for nighttime feedings, they can develop a pattern of sleep disruption which can last well past their baby’s infancy.
According to Dr. Haber there are some things that you can do to get a better night’s sleep and win the battle against insomnia. Here are some suggestions:
- The bedroom should be a comfortable, dark and quiet setting.
- Avoid exercising right before bedtime.
- Keep regular sleep and wake time schedules.
- The bedrooms shouldn’t be used as an office, family rooms, etc. in order to reinforce the connection between bedtime and sleep onset.
- Don’t spend more than twenty minutes in bed waiting to fall asleep. Instead, get up and do a relaxing activity until you feel sleepy.
- If you find yourself worried about the next day’s activities, try making a “to-do” list so you will know you haven’t forgotten anything.
- Don’t watch the clock.
- Avoid stimulants such as caffeine.Insomnia can often be treated very successfully just by making these types of changes, but not always. “If there are specific features of sleep disruption identified by the patient or a bed partner, such as snoring with witnessed breathing pauses (apneas), leg movements at night, nighttime wheeze/heartburn or unusual nighttime behaviors (sleep walking, acting out dreams, etc.) a referral to a sleep specialist is recommended.” advises Dr. Haber.There are a wide range of treatment options available. If the problem is related to emotional or mental issues, counseling is often recommended. Relaxation therapy can also be useful. Anti-depressants or anti-anxiety medications may be prescribed if insomnia is triggered by either of these. Sleeping pills are sometimes given, but only for short periods of time since they can be habit forming. Of course, if insomnia is related to another medical condition specific treatment aimed at the condition is needed.Getting a good night’s sleep is one of the most important things that you can do to keep yourself healthy. By understanding what causes insomnia you will be better able to overcome it. You will be more productive, in a better mood, and ready to face the day.Alan D. Haber, M.D. is Chief of Pulmonary Medicine and Director of the Sleep Laboratory at Graduate Hospital in Philadelphia.
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